| Object:Conclude the the syndrome elements distribution characteristics and their combination of multiple sclerosis by a comprehenslve literature analysis. According to the results of our literature research, starting from the clinical four diagnostic information in the form of syndrome elements, proposed the<the multiple sclerosis syndrome factors diagnosis scale>, to provide effective and convenient tool for TCM syndrome differentiation and treatment of multiple sclerosis clinical use.Methods:(1)Literature research:by screening and study the domestic literature about diagnosis and treatment in traditional Chinese medicine of multiple sclerosis In China journal full-text database (CNKI), to summarize the distribution of different syndrome of traditional Chinese medicine literature in multiple sclerosis, statistics the patient cases of each syndrome type of traditional Chinese medicine in multiple sclerosis, statistics the syndromes elements and to analyze its regularity in multiple sclerosis.(2) Clinical research:by the method of epidemiological cross-sectional survey,collect patients four diagnostic data by<multiple sclerosis TCM four diagnostic information questionnaire>, according to the four diagnostic information, by the method of unsupervised entropy clustering data mining with the experts recognition and interpretation to extract the syndrome elements and entry information, the entries for multivariate logistic regression, draw each item of partial regression coefficient of each syndrome elements,give the assignment according to the proportion. As gold standard of experts dialectic, according to the assignment of ROC curve assigned with the diagnostic threshold of each syndrome elements, retrospective test the table specificity and sensitivity, to completed the<the multiple sclerosis syndrome elements diagnosis scale>.Results:(1) Li terat ure research:literatures including from1990to2012,24literatures were selected in accordance with the inclusion criteria, literatures involved a total of1280cases, involved10kinds of syndrome types, those are Liver and kidney Yin deficiency, liver and kidney Yin deficiency, and other empirical, spleen kidney Yang deficiency, spleen kidney Yang deficiency, and other empirical, phlegmy wet winding resistance, the blood stasis blocking col laterals, spleen qi deficiency, lung and spleen deficiency, deficiency of Yin and Yang and wind phlegm blocking collaterals respectively. There were10kinds of TCM syndrome elements in literatures, the disease location kind of syndrome elements isKidney, liver, spleen and collaterals respectively, disease type of syndrome elements is Yin deficiency, Yang deficiency, blood stasis, phlegm heal and phlegm dampness and wind respectively.(2) Clinical research:collected500cases of patients with multiple sclerosis,105four diagnostic data were collected, entropy clustering results45classes, by experts to identify and interpret the results, according to the characteristics of data and expert interpretation finally summarized as liver and kidney Yin deficiency, spleen kidney Yang deficiency, spleen qi deficiency, blood stasis, phlegm dampness phlegm hot and dynamic wind6syndrome element set. The sesluls of empowerment the syndrome factors of TCM symptoms entries and determine the syndrome elements of diagnostic threshold is:(1) liver and kidney Yin deficiency (diagnosis tihreshold value was16.5):symptoms worse when it is heated5, night sweats3, Fits baking hot1, feverishness in palms and soles7, double vision1, decreased vision1, bone steaming hot flashes4, waist and knee pain1, heel pain1, acid heavy pain5, forgetfulness1, irritability1, zygoma tic red2, red tongue6,less moss1,pulse fine8.(2) spleen kidney Yang deficiency (diagnosis lihreshold value wasl3.5): encounter cold symptoms worse1, cold limbs2, limb is cold5, cold limbs joint pain2, joint stiffness4, face white complexion2, chills often4, weakness move the bowels1,constipation defecate1, urinary incontinence4, urorrhea2, impotence1, decreased libido2, hypophrenia1, hearing loss1,pules deep4.(3) spleen qi deficiency (diagnosis t ihreshold value was8.5):t i red after the symptom is aggravating1, languid trapped4, body trapped back2,eat less4, face no light2, Since the sweat2, sweating3, tastelessness in the mouth4, Moss white greasy2.(4) phlegm dampness phlegm hot (diagnos is tihreshold value was8.5):body trapped back1, such as wrapped on his head2, dizzy4, double vis ion1, decreased vision1, heel pain1, acid heavy pain2, vomiting2, acraturesis2, Moss white greasy5, Moss yellow greasy6, smooth pulse6,slip pulse2.(5) blood stasis (diagnos is t ihreshold value was6.5):skin numbness4, local feel t ightness or band arrested2, limb spasm1, limb stabbing pain2, face gloomy2, face dark2,dark tongue8, tight pulse7.(6) dynamic wind (diagnosis tihreshold value was5.5):limb spasm1, dizzy1, Limb and head shaking4, ghysical tics5, double vision1, top-heavy1, Pulse string2. Complete "the syndrome elements of multiple sclerosis diagnosis scale", each of syndrome elements of the scale in sensitivity between0.857-0.971, specificity between0.853-0.957Conclusions:(1) Literature research:the literature shows TCM syndrome type of Multiple sclerosis liver and kidney Yin deficiency and other empirical, liver and kidney Yin deficiency, spleen kidney Yang deficiency, blood stasis blocking col laterals in patients with larger proportion. The majority of patients show is two, three or four kinds of disease type of syndrome elements mutual combination of irregular syndromes. disease type of syndrome elements with Yin deficiency, blood stasis syndrome elements distribution is the most widespread common, can be combined with other syndrome element s of free expression in multiple sclerosis patients.(2) Clinical research: Clinical research is established in the six characteristics response to multiple sclerosis disease syndromes elements combination. By compared with expert differentiation of retrospective survey, the scale has good sensitivity and specificity, as to meet the requirements of clinical application. |
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